- AdventHealth (Altamonte Springs, FL)
- …Team of any coding or coding related issues that adversely impact the claims processing, coding accuracy, and compliance.e. Monitors the queue holds and adhere to ... all hold timelines, releasing on your own accord when appropriate.f. Consistently maintains productivity and accuracy standards as outlined by Coding leadership.g. Review and correct coding on accounts and makes changes as appropriate.1. Demonstrates attention… more
- Walmart (Miramar, FL)
- …in accordance with Company policies and procedures by properly handling claims and returns, zoning the area, arranging and organizing merchandise/supplies, ... identifying shrink and damages, and ensuring a safe work environment. Maintains merchandise presentation in the Pharmacy by stocking and rotating merchandise, removing damaged or out-of-date goods, setting up, cleaning, and organizing product displays, signing… more
- BayCare Health System (Tampa, FL)
- …correction of charges, edits, and registration/insurance issues in order to provide clean claims for large volume areas. + Requires attention to detail as well as ... the ability to function in various information system platforms. + Must discuss with provider when discrepancies present. + Appropriate utilization of CPT, ICD-10, and HCPCS codes. + May serve as back up for non-clinical team and perform other duties as… more
- Centene Corporation (New Port Richey, FL)
- …care or medical group experience, provider relations, quality improvement, claims , contracting utilization management, or clinical operations. Project management ... experience at a medical group, IPA, or health plan setting. Proficient in HEDIS/Quality measures, cost and utilization.Pay Range: $55,100.00 - $99,000.00 per year Centene offers a comprehensive benefits package including: competitive pay, health insurance,… more
- AssistRx (Orlando, FL)
- …to expedite patient access + Document and initiate prior authorization process and claims appeals + Report any reimbursement trends or delays in coverage to ... management + Act as a liaison for field representatives, health care providers and patients Job Details Snapshot: + Compensation: $19-22/hr + Language Differential: In addition to your base hourly compensation, you will also receive a language skills… more
- Bank of America (Miami, FL)
- …Self-motivated and results-oriented with excellent organizational skills **Skills:** + Claims Management + Controls Management + Monitoring, Surveillance, and ... Testing + Policies, Procedures, and Guidelines Management + Quality Assurance + Attention to Detail + Investigation Management + Problem Solving + Risk Management + Written Communications + Adaptability + Process Management + Process Mapping + Project… more
- University of Miami (Miami, FL)
- …to customer inquiries regarding insurance coverage of services and processing of claims . + Follows appropriate procedures to link alternative insurance plan payers ... to the appropriate programs during registration. + Identifies non-contracted HMO payers and refers to proper managing department. + Serves as a lead Insurance Verification Representative and assists in training new staff. + Adheres to University and unit-level… more
- Cardinal Health (Tallahassee, FL)
- …laws and regulations, (eg, Stark, Corporate Practice of Medicine, Anti-Kickback, False Claims Act, and HIPAA); and Marketing and Advertising + Proactively identify ... and assesses business and legal risks + Demonstrate excellent communication skills and ability to provide business clients with clear and precise guidance on business, compliance, and legal risks + Develop and conduct legal training for business clients + Seek… more
- Sumitomo Pharma (Tallahassee, FL)
- …submissions by preparing responses to agency inquiries and contributing to labeling claims . + Review Case Report Forms (CRFs) to ensure data collection aligns ... with protocol-defined analyses. + Develop data presentation plans and design Table, Listing, and Figure (TFL) shells. + Provide guidance to statistical programmers on SDTM/ADaM datasets and TLF specifications. + Perform programming validation for key derived… more
- Molina Healthcare (FL)
- …& ABILITIES** : * 2 - 3 years customer service, provider service, or claims experience in a managed care setting. * Working familiarity with various managed ... healthcare provider compensation methodologies, primarily across Medicaid and Medicare lines of business, including but not limited to, fee-for service, capitation and various forms of risk, ASO, etc. **PREFERRED EDUCATION** : Bachelor's Degree in a related… more